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Achilles Tendinopathy

Published: 25 May 2025

Why Your Achilles Hurts – and What You Can Do About It

Achilles pain is a common issue that affects people of all activity levels, from runners and elite athletes to those just going about everyday life. In children, it often appears as Sever’s disease, but in adults, the most common cause is Achilles tendinopathy. This blog
focuses on what that is, why it happens, and how you can manage it.

What Is Achilles Tendinopathy?

Your calf is made up of two main muscles, the gastrocnemius and soleus. These join to form the achilles tendon, connecting your calf to your heel. This tendon plays a crucial role
in walking, running, and jumping. Common symptoms of achilles tendinopathy include:

• Pain in or around the achilles tendon (may warm up with activity in early stages, but worsen later)
• Morning stiffness that improves with movement
• Swelling or thickening of the tendon
• Tenderness to touch
• Pain when pushing off the foot during walking, running, or jumping

What Causes Achilles Tendinopathy?

Achilles tendinopathy can be caused by both internal and external factors:

Internal factors:

• Age: Natural changes in blood flow and tendon structure make it more prone to injury.
• Hormonal changes: During menopause or perimenopause, oestrogen levels reduce, which lowers collagen production and makes tendons more prone to stiffness and injury.
• Increased body weight: Adds stress to the tendon.
• Certain medications: Corticosteroids or some antibiotics.

External factors:

• Repetitive strain: Common in running, jumping, and sports with quick direction changes.
• Sudden increases in activity: Doing too much too quickly without proper progression.

What Can You Do?

The good news is that Achilles tendinopathy can improve with the right approach. Here’s what can help:

• See a physiotherapist for a proper diagnosis and a tailored exercise plan.

Our physiotherapists will thoroughly assess your Achilles injury to accurately diagnose and develop the most effective management approach.

• Activity modification to reduce tendon load (e.g. reducing running volume).
• Individualised exercise program prescribed by your treating physiotherapist
• Manual therapy can help release tension around the tendon.
• Shockwave therapy may be used in stubborn cases to promote healing.

Take-Home Message

• Act early: The sooner you start treatment, the better.
• Listen to your body: Working within safe pain limits.
• Be patient: Recovery takes time, and ups and downs are normal.
• Get help: A physiotherapist can guide you safely back to pain-free movement.